In a nutshell

This study investigated whether sodiumtanshinone IIA sulfate (STS) plus atorvastatin (Lipitor) would be more effective at lowering high-sensitivity C-reactive protein (hs-CRP) levels than atorvastatin alone. It was determined that the combination reduced hs-CRP levels more than atorvastatin alone.

Some background

Coronary artery disease (CAD) is a condition caused by narrowing of blood vessels that supply the heart. This reduces the supply of blood to the heart. This can lead to unstable angina (severe chest pain, even while resting) or a heart attack.

High levels of hs-CRP have been linked to an increased risk of developing CAD complications, like heart attacks. Thus, reducing hs-CRP levels may be useful in people with CAD. hs-CRP is a marker of inflammation. This means that blood levels of hs-CRP are high when inflammation is high (like in infections or immune reactions). Other markers of inflammation may also be elevated in people with CAD.

Atorvastatin is one of the drugs used to treat CAD. It reduces levels of cholesterol in the blood and reduces inflammation. STS is a newer drug that may decrease the levels of many markers of inflammation, including hs-CRP.

Methods & findings

70 adults with CAD, who had high levels of hs-CRP, participated in this study. 63 had unstable angina, and 7 had had a heart attack. They were randomly divided into two groups. One group received atorvastatin (control group). The other group received atorvastatin and STS (experimental group). STS was given as an injection once daily for 14 days. The participants were followed up for 30 days after completing treatment.

Levels of hs-CRP were similar between the two groups at the start of the study. After 14 days hs-CRP levels fell in both groups, but were lower in the experimental group. 30 days after completing treatment, levels in both groups were similar, but still lower than at the start of the study.

Several other markers of inflammation were examined in this study. All were decreased in both groups after 14 days. Three of these (IL-6, MCP-1, and sCD40L) were lower in the experimental group than in the control group. 30 days after completing treatment, all markers of inflammation were still decreased, except for sVCAM1 in both groups, and sCD40L in the control group.

Symptoms of angina were better controlled in the experimental group than in the control group. This was seen after 14 days and 30 days after completing treatment. No serious adverse events (such as bleeding, heart attack, stroke, or death) occurred.

The bottom line

The study concluded that STS combined with atorvastatin was better than atorvastatin alone at reducing hs-CRP, and some other markers of inflammation. The combination was also better at controlling symptoms of angina, and did not increase the risk of side effects.

The fine print

This study examined only a small number of participants for a short period of time. Although hs-CRP was reduced, it is not certain whether this will lead to fewer complications of CAD. The manufacturers of STS funded this study.